Physical activity promotion in primary care: Bridging the gap between research and practice

Background: Aflifle a growing literature supports the effectiveness of physical activity interventions delivered in the primary care setting, few studies have evaluated efforts to increase physician counseling on physical activity during routine practice (i.e., outside the context of controlled research). This paper reports the results of a dissemination trial of a primary care-based physical activity counseling intervention conducted within the context of a larger, multi-strategy, Australian community-based, physical activity intervention, the 10,000 Steps Rockhampton Project. Methods: All 23 general practices and 66 general practitioners (GPs, the Australian equivalent of family physicians) were invited to participate. Practice visits were made to consenting practices during which instruction in brief physical activity counseling was offered, along with physical activity promotion resources (print materials and pedometers). The evaluation, guided by the RE-AIM framework, included collection of process data, as well as pre-and post-inteivention data from a mailed GP survey, and data from the larger project's random-digit-dialed, community-based, cross-sectional telephone survey that was conducted in Rockhampton and a comparison community, Results: Ninety-one percent of practices were visited by 10,000 Steps staff and agreed to participate, with 58% of GPs present during the visits. General practitioner survey response rates were 67% (n =44/66 at baseline) and 71% (n =37/52, at 14-month follow-up). At follow-up, 62% had displayed the poster, 81% were using the brochures, and 70% had loaned pedometers to patients, although the number loaned was relatively small. No change was seen in GP self-report of the percentage of patients counseled on physical activity. However, data from the telephone surveys showed a 31% increase in the likelihood of recalling GP advice on physical activity in Rockhampton (95% confidence interval [CI]=1.11-1.54) compared to a 16% decrease (95% CI=0.68-1.04) in the comparison community. Conclusions: This dissemination study achieved high rates of GP uptake, reasonable levels of implementation, and a significant increase in the number of community residents counseled on physical activity. These results suggest that evidence-based primary care physical activity counseling protocols can be translated into routine practice, although the initial and ongoing investment of time to develop partnerships with relevant healthcare organizations, and the interest generated by the overall 10,000 Steps program should not be underestimated. ((C) 2004 American journal of Preventive Medicine.

"mind the gap": The size-distance dissociation in visual neglect is a cueing effect

There is a growing body of evidence that the processes mediating the allocation of spatial attention within objects may be separable from those governing attentional distribution between objects. In the neglect literature, a related proposal has been made regarding the perception of (within-object) sizes and (between-object) distances. This proposal follows observations that, in size-matching and bisection tasks, neglect is more strongly expressed when patients are required to attend to the sizes of discrete objects than to the (unfilled) distances between objects. These findings are consistent with a partial dissociation between size and distance processing, but a simpler alternative must also be considered. Whilst a neglect patient may fail to explore the full extent of a solid stimulus, the estimation of an unfilled distance requires that both endpoints be inspected before the task can be attempted at all. The attentional cueing implicit in distance estimation tasks might thus account for their superior performance by neglect patients. We report two bisection studies that address this issue. The first confirmed, amongst patients with left visual neglect, a reliable reduction of rightward error for unfilled gap stimuli as compared with solid lines. The second study assessed the cause of this reduction, deconfounding the effects of stimulus type (lines vs. gaps) and attentional cueing, by applying an explicit cueing manipulation to line and gap bisection tasks. Under these matched cueing conditions, all patients performed similarly on line and gap bisection tasks, suggesting that the reduction of neglect typically observed for gap stimuli may be attributable entirely to cueing effects. We found no evidence that a spatial extent, once fully attended, is judged any differently according to whether it is filled or unfilled.

The Debreu Gap Lemma and some generalizations

In this paper we study the Debreu Gap Lemma and its generalizations to totally ordered sets more general than (R, less than or equal to). We explain why it is important in economics to study utility functions which may not be real-valued and we build the foundations of a theory of continuity of such generalized utility functions. (C) 2004 Published by Elsevier B.V.

Gap-junction communication between subtypes of direction-selective ganglion cells in the developing retina

The On-Off direction-selective ganglion cells (DSGCs) in the rabbit retina comprise four distinct subtypes that respond preferentially to image motion in four orthogonal directions; each subtype forms a regular territorial array, which is overlapped by the other three arrays. In this study, ganglion cells in the developing retina were injected with Neurobiotin, a gap-junction-permeable tracer, and the DSGCs were identified by their characteristic type 1 bistratified (BiS1) morphology. The complex patterns of tracer coupling shown by the BiSl ganglion cells changed systematically during the course of postnatal development. BiSl cells appear to be coupled together around the time of birth, but, over the next 10 days, BiSl cells decouple from each other, leading to the mature pattern in which only one subtype is coupled. At about postnatal day 5, before the ganglion cells become visually responsive, each of the BiSl cells commonly showed tracer coupling both to a regular array of neighboring BiSl cells, presumably destined to be DSGCs of the same subtype, and to a regular array of overlapping BiSl cells, presumably destined to be DSGCs of a different subtype. The gap-junction intercellular communication between subtypes of DSGCs with different preferred directions may play an important role in the differentiation of their synaptic connectivity, with respect to either the inputs that DSGCs receive from retinal interneurons or the outputs that DSGCs make to geniculate neurons. (C) 2004 Wiley-Liss, Inc.

Three-dimensional solitons in coupled atomic-molecular Bose-Einstein condensates

We present a theoretical analysis of three-dimensional (3D) matter-wave solitons and their stability properties in coupled atomic and molecular Bose-Einstein condensates (BECs). The soliton solutions to the mean-field equations are obtained in an approximate analytical form by means of a variational approach. We investigate soliton stability within the parameter space described by the atom-molecule conversion coupling, the atom-atom s-wave scattering, and the bare formation energy of the molecular species. In terms of ordinary optics, this is analogous to the process of sub- or second-harmonic generation in a quadratic nonlinear medium modified by a cubic nonlinearity, together with a phase mismatch term between the fields. While the possibility of formation of multidimensional spatiotemporal solitons in pure quadratic media has been theoretically demonstrated previously, here we extend this prediction to matter-wave interactions in BEC systems where higher-order nonlinear processes due to interparticle collisions are unavoidable and may not be neglected. The stability of the solitons predicted for repulsive atom-atom interactions is investigated by direct numerical simulations of the equations of motion in a full 3D lattice. Our analysis also leads to a possible technique for demonstrating the ground state of the Schrodinger-Newton and related equations that describe Bose-Einstein condensates with nonlocal interparticle forces.

Identifying the energy gap: Magnitude and determinants of 5-year weight gain in midage women

Objective: The aims of this study were to estimate average yearly weight gain in midage women and to identify the determinants of weight gain and gaining weight at double the average rate. Research Methods and Procedures: The study sample comprised 8071 participants (45 to 55 years old) in the Australian Longitudinal Study on Women's Health who completed mailed surveys in 1996, 1998, and 2001. Results: On average, the women gained almost 0.5 kg per year [average 2.42 kg (95% confidence interval, 2.29 to 2.54) over 5 years]. In multivariate analyses, variables associated with energy balance (physical activity, sitting time, and energy intake), as well as quitting smoking, menopause/hysterectomy, and baseline BMI category were significantly associated with weight gain, but other behavioral and demographic characteristics were not. After adjustment for all of the other biological and behavioral variables, the odds of gaining weight at about twice the average rate (> 5 kg over 5 years) were highest for women who quit smoking (odds ratio = 2.94; 95% confidence interval, 2.17, 3.96). There were also independent relationships between the odds of gaining > 5 kg and lower levels of habitual physical activity, more time spent sitting, energy intake (but only in women with BMI > 25 at baseline), menopause transition, and hysterectomy. Discussion: The average weight gain equates with an energy imbalance of only about 10 kcal or 40 kJ per day, which suggests that small sustained changes in the modifiable behavioral variables could prevent further weight gain.

Survey-gap analysis in expeditionary research: where do we go from here?

Research expeditions into remote areas to collect biological specimens provide vital information for understanding biodiversity. However, major expeditions to little-known areas are expensive and time consuming, time is short, and well-trained people are difficult to find. In addition, processing the collections and obtaining accurate identifications takes time and money. In order to get the maximum return for the investment, we need to determine the location of the collecting expeditions carefully. In this study we used environmental variables and information on existing collecting localities to help determine the sites of future expeditions. Results from other studies were used to aid in the selection of the environmental variables, including variables relating to temperature, rainfall, lithology and distance between sites. A survey gap analysis tool based on 'ED complementarity' was employed to select the sites that would most likely contribute the most new taxa. The tool does not evaluate how well collected a previously visited site survey site might be; however, collecting effort was estimated based on species accumulation curves. We used the number of collections and/or number of species at each collecting site to eliminate those we deemed poorly collected. Plants, birds, and insects from Guyana were examined using the survey gap analysis tool, and sites for future collecting expeditions were determined. The south-east section of Guyana had virtually no collecting information available. It has been inaccessible for many years for political reasons and as a result, eight of the first ten sites selected were in that area. In order to evaluate the remainder of the country, and because there are no immediate plans by the Government of Guyana to open that area to exploration, that section of the country was not included in the remainder of the study. The range of the ED complementarity values dropped sharply after the first ten sites were selected. For plants, the group for which we had the most records, areas selected included several localities in the Pakaraima Mountains, the border with the south-east, and one site in the north-west. For birds, a moderately collected group, the strongest need was in the north-west followed by the east. Insects had the smallest data set and the largest range of ED complementarity values; the results gave strong emphasis to the southern parts of the country, but most of the locations appeared to be equidistant from one another, most likely because of insufficient data. Results demonstrate that the use of a survey gap analysis tool designed to solve a locational problem using continuous environmental data can help maximize our resources for gathering new information on biodiversity. (c) 2005 The Linnean Society of London.

On bridging the gap: The relevance of theory to the practice of conflict resolution

It is often claimed that policy makers and scholars inhabit different worlds and have little for each other. We challenge this perception and claim that there is a strong symbiotic relationship between the two. This relationship is particularly strong in the field of conflict where policy makers may be in desperate need of guidelines, advice and analysis on how to transform complex conflict situations into more peaceful ones. We suggest that policy makers may think in terms of macro and micro-level theories and ideas if they wish to embrace better strategies of conflict resolution.

Behaviour of the energy gap in a model of Josephson coupled Bose-Einstein condensates

In this work we investigate the energy gap between the ground state and the first excited state in a model of two single-mode Bose-Einstein condensates coupled via Josephson tunnelling. The ene:rgy gap is never zero when the tunnelling interaction is non-zero. The gap exhibits no local minimum below a threshold coupling which separates a delocalized phase from a self-trapping phase that occurs in the absence of the external potential. Above this threshold point one minimum occurs close to the Josephson regime, and a set of minima and maxima appear in the Fock regime. Expressions for the position of these minima and maxima are obtained. The connection between these minima and maxima and the dynamics for the expectation value of the relative number of particles is analysed in detail. We find that the dynamics of the system changes as the coupling crosses these points.

Amodal completion with background determines depth from monocular gap stereopsis

Grove, Gillam, and Ono [Grove, P. M., Gillam, B. J., & Ono, H. (2002). Content and context. of monocular regions determine perceived depth in random dot, unpaired background and phantom stereograms. Vision Research, 42, 1859-1870] reported that perceived depth in monocular gap stereograms [Gillam, B. J., Blackburn, S., & Nakayama, K. (1999). Stereopsis based on monocular gaps: Metrical encoding of depth and slant without matching contours. Vision Research, 39, 493-502] was attenuated when the color/texture in the monocular gap did not match the background. It appears that continuation of the gap with the background constitutes an important component of the stimulus conditions that allow a monocular gap in an otherwise binocular surface to be responded to as a depth step. In this report we tested this view using the conventional monocular gap stimulus of two identical grey rectangles separated by a gap in one eye but abutting to form a solid grey rectangle in the other. We compared depth seen at the gap for this stimulus with stimuli that were identical except for two additional small black squares placed at the ends of the gap. If the squares were placed stereoscopically behind the rectangle/gap configuration (appearing on the background) they interfered with the perceived depth at the gap. However when they were placed in front of the configuration this attenuation disappeared. The gap and the background were able under these conditions to complete amodally. (c) 2006 Elsevier Ltd. All rights reserved.